Provider Demographics
NPI:1922425438
Name:OURAY FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:OURAY FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-325-4800
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:OURAY
Mailing Address - State:CO
Mailing Address - Zip Code:81427-0648
Mailing Address - Country:US
Mailing Address - Phone:970-325-4800
Mailing Address - Fax:970-325-4805
Practice Address - Street 1:309 6TH AVENUE
Practice Address - Street 2:
Practice Address - City:OURAY
Practice Address - State:CO
Practice Address - Zip Code:81427
Practice Address - Country:US
Practice Address - Phone:970-325-4800
Practice Address - Fax:970-325-4805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN00202078261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental